# DPMLEONHEARTPRWA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326229485
- **Authorized official:** ERIC EDWARD LEONHEART (OWNER)
- **Authorized official phone:** (253) 841-3668

## Contact information

- **Practice address:** 10116 116TH ST E, SUITE 103, PUYALLUP, WA 98373-3543
- **Practice address phone:** (253) 841-3668
- **Mailing address:** 11201 88TH AVE E, SUITE 210, PUYALLUP, WA 98373-3802
- **Mailing address phone:** (253) 841-3668
- **Mailing address fax:** (253) 841-0878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO00000778 | WA | Yes |

## Other

- **Enumeration date:** 11/16/2007
- **Last updated:** 10/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1121714 | — | WA |